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First time mom, low supply. Help!

I had my little one just about 3 weeks ago. I started nursing at the hospital after having a C-Section and everything seemed fine. We went home 2 days after delivery. On day 4, she started getting really fussy and you could hear her tummy rumbling/gurgling. I thought it was possibly just something I ate that did not agree with her little system. On day 5 we called our pediatrician, explained what was happening and he suggested that we give her formula and that I pump to see how much I was producing. I only pumped 5 ml's. I feel so horrible about starving her for a day and a half!!

I saw my doctor who prescribed Reglan. I am currently on day 12 and my milk production is only up to 7-10 ml's every 2-3 hours.

Our pediatrician told us to just add these ml's to the formula bottles. I so wanted to have a breastfed baby.

A little back history: In 2006 I had breast augmentation, above the muscle. The doctor swore that it would have no negative effect on breastfeeding. Of course he would say that wouldn't he?

I have two questions:

1. Is the 7-10 ml's really helping her get the antibodies and such that I so desperately want her to have? Quite a few people are telling me that it's not worth the effort of pumping every 2-3 hours.

2. Is there anything else I should do/take to get my supply up more? I've been reading about Fenugreek, Blessed Thistle, Red Rasberry, Mothers Milk Tea... It's all a bit overwelming to me. Should these things be taken in conjunction with the Reglan? Is this a question better suited for my doctor??

I'm trying really hard to do what is best for her and not quit if my little bit is helping. Also, I am trying to not be discouraged. I wanted to be that mom that breastfed for as long as possible.

Any help, suggestions or general feedback would be greatly appreciated.

Re: First time mom, low supply. Help!

I have to say, I am no expert, but I had/have a very similar experience. I too have an extremely low milk supply. I started out getting what you are getting.

In terms of what you should do to increase your supply. . .you need to pump with a hospital grade pump every 2-3 hours for as long as you can. You also have to make sure the shields you are using are the proper size for you. I would pump for 20-40 minutes at a time. I think you are supposed to pump for a5-7 minutes after the milk stops. You can also try pumping on and off in 10 minute intervals. I take fenugreek, blessed thistle and Domperidone. I would be careful with Reglan, it can cause some serious side effects, especially if taken over 30 days.

I can't answer the question about how much milk is necessary for the immunities to be passed on, but I've read that any breastmilk is better than none. Also, you may get your supply up to more than you think. My babies are over 4 months now and I am down to pumping 7-8 times a day because I am back at work, but I make about 15-20 oz a day now. Obviously that's no where near a full supply for twins, but I will give them whatever I can for as long as I can. For the first two weeks or so, I would pump only 5-15ml. Don't give up!

I don't know anything about breast surgery, but I've read this site http://bfar.org/

I have latch issues, so for me, it's important to have my boys latch as much as possible. I try to get them on as much as possible. You should too, even if you don't have latch issues. Skin to skin contact is also really important. Oh and try not to stress, you can only do what you can. Stressing about it will only make it worse. Try to watch tv or something to get your mind off of obsessing over how much you are getting.

Re: First time mom, low supply. Help!

Welcome and congratulations on the new baby! I am sorry you ran into a major hurdle so soon. But hopefully there's some way to resolve it.

I know that breast surgeries can screw up breastfeeding, which is why this site exists: http://bfar.org/. I have read that surgeries where the nipple/areola is severed and reattached are the ones most likely to cause issues- does that apply in your case?

I am a bit suspicious of your pediatrician's advice that first time you called. In general, pumping is a poor substitute for nursing, since most pumps don't empty the breast as well as most babies. So I have some questions for you that might help determine how things were really going before you got roped into supplementing.
- When your baby was exclusively breastfed, how was her diaper output (in terms of number of wet and poopy diapers per day)? Did she pass her meconium within a few days of birth, and after that, what were her stool like (yellow and the consistency of thin yogurt or cottage cheese, or greenish and watery)?
- How was your baby's weight before you started supplementing?

Are you currently nursing at all, or are you exclusively pumping? And what sort of pump are you using?

You can feel free to take Mother's Milk Tea or fenugreek in conjunction with Reglan- unless you are diabetic, in which case you should talk to your doc about fenugreek, as it has been known to lower blood sugar.

If you are stuck in a low supply situation- and this is by no means guaranteed- whether or not you continue to nurse is up to you. Whatever amount of breastmilk you produce will be beneficial for your baby, and it is beneficial for you, purely on health grounds, to continue to make milk.

Re: First time mom, low supply. Help!

Hi ceri, I'm glad you found us!

I've got the same questions as mommal... What kind of pump are you using? How was your baby's weight and diaper output that first week (if you can remember; I know it can be a blur!)? Are you nursing her at the breast at all now?

Breast surgery can be a factor in milk supply, usually breast reduction is more likely to cause problems than augmentation. Determining how much milk you have actually isn't as straightforward as it seems like it ought to be. Some indicators are --

- Baby's weight gain. This is the best indicator of how well breastfeeding is going. If baby is gaining weight at an appropriate rate, then breastfeeding is working. If baby is gaining slowly or not at all, we look for a reason why. It may be that mom's milk supply is low, or it may be that baby isn't latching well or transferring milk effectively. Rarely, the baby is getting plenty of milk, but isn't able to absorb the nutrients.

- Diaper output. In the first few weeks, 6+ wet diapers and 3+ yellow, soft, liquidy or seedy bowel movements every 24 hours is a good general indicator that baby is taking in enough milk.

- Weighing before and after feedings. This is something that may be helpful to see how much milk the baby is really transferring when nursing at the breast, but you'd need to work with a lactation consultant to make sure it's done correctly.

How much you can pump is not a good indicator of milk supply. There are so many other things that can affect it -- what kind of pump you're using, how your body responds to the pump, how much experience you have pumping, what time of day it is, etc.

I'd definitely suggest meeting with a board certified lactation consultant (IBCLC) to help you figure out if the breast augmentation is causing a problem here, or if something else entirely is going on. You can check the ILCA website to find an IBCLC near you.

Re: First time mom, low supply. Help!

After we gave her that first bottle, she wanted nothing to do with my breast. I am using the Modela PIS to so I can add the milk I do produce to her formula bottles.

She has JUST (3 weeks old tomorrow) started to have bowel movements regularly on her own. This was another big worry for us. She would go 2-3 days with no movements, tons of gas though. I believe this is why our pediatrician suggested giving her formula when she was so fussy and upset with us. However, she has always wet her diapers like a champ.

She weighed 8lbs at birth, 7lb 4oz at her first visit to the pediatrician a week later. We started giving her formula 5 days after birth. Her appointment with the pediatrician was 2 days after that.

EDIT: She was back to her birth weight within a week after giving her formula and she's gaining 1 - 2 oz a day now. She passed meconium immediately after birth and once a day for the next 2 or 3 days. During that time she had 1 wet diaper per day. When we switched to formula, her wet diapers increased to 5 or 6 per day but no bowel movements until we were instructed to give her a suppository. That worked, but we we had to continue that every 3 or 4 days but now she is having bowel movements on her own once or twice a day. It is greenish yellow.

Re: First time mom, low supply. Help!

Thanks for posting all that, mama. Based on what you've written, it seems like you did get the right advice from the doc. 1 wet diaper per day is not what you want to see for 3 days in a row. And if your implants were put in through the areola- AFAIK that is a scenario that is more likely to cause issues with breastfeeding than with inframammary insertion (when the implant comes in from the crease at the base of the breast). So it seems reasonable to think that yes, your issues with milk production are real, and not just a matter of improper breastfeeding management.

In your shoes, I would want to do the following:
1. See a lactation consultant, preferably an IBCLC, as suggested by LLLKaren. She can tell you way better than we can whether or not your baby is getting enough from the breast to allow you to phase out the supplements, and can help you troubleshoot your pumping routine- maybe there is a way to yield more (like using a hospital-grade pump or a different shield size).
2. Renting a professional scale and doing your own test weights at home. One weigh-feed-weigh test won't tell you a whole lot because milk intake varies a lot. But average a day's worth of measurements and you will gain a more complete picture.
3. Talk to your doc about using a different type of formula? Admittedly, I do not know much about formula, but my understanding is that some babies have more trouble processing different types of formula, and that sort of issue could be responsible for your baby's poop issues.

Re: First time mom, low supply. Help!

Oh mu goodness... I am so glad that I just found this forum... this sounds a lot like my situation! I am going to post my own thread to see if I get any different advice, but I am so glad to see people in my same situation! (Well, not glad that people are in the situation, but glad that I am not alone!)